Cardiac allograft vasculopathy

Do adipocytes bridge alloimmune and metabolic risk factors?

Jennifer R. Wehner, William M. Baldwin

Research output: Contribution to journalArticle

Abstract

Purpose Of Review: Cardiac allograft vasculopathy (CAV) is still a major cause of chronic graft failure. CAV develops in the coronary arteries as a diffuse, concentric expansion of the intima in conjunction with inflammation and fibrosis of the adventitia. We review recent publications that could link metabolic and immunologic risk factors for CAV.A concept is offered that periarterial adipocytes may provide proinflammatory cytokines that augment immune injury of the coronary arteries. Recent Findings: Clinical and experimental evidence indicate that some alloantibodies and autoantibodies are associated with CAV. Limited data are available on the expression of target antigens on coronary arteries at different times after transplantation. Perivascular adipose tissue is an abundant source of IL-6, IL-8 and MCP-1. Adding to the inflammatory bias, perivascular adipocytes secrete less of the anti-inflammatory adiponectin in comparison to other types of fat. Adiponectin modulates expression of adhesion molecules on the vascular endothelium. It also decreases neointimal formation in arteries following mechanical endovascular injury. Summary: Alterations in the balance between proinflammatory and anti-inflammatory cytokines secreted by perivascular fat have been implicated in atherosclerosis and restenosis. This imbalance may also augment the immune responses in the coronary arteries of transplanted hearts.

Original languageEnglish (US)
Pages (from-to)639-644
Number of pages6
JournalCurrent Opinion in Organ Transplantation
Volume15
Issue number5
DOIs
StatePublished - Oct 2010
Externally publishedYes

Fingerprint

Adipocytes
Allografts
Coronary Vessels
Adiponectin
Anti-Inflammatory Agents
Fats
Cytokines
Isoantibodies
Adventitia
Vascular Endothelium
Wounds and Injuries
Immunologic Factors
Interleukin-8
Autoantibodies
Adipose Tissue
Interleukin-6
Atherosclerosis
Fibrosis
Arteries
Transplantation

Keywords

  • adiponectin
  • antibody-mediated rejection
  • perivascular adipose tissue
  • proinflammatory cytokines
  • vasculopathy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation

Cite this

Cardiac allograft vasculopathy : Do adipocytes bridge alloimmune and metabolic risk factors? / Wehner, Jennifer R.; Baldwin, William M.

In: Current Opinion in Organ Transplantation, Vol. 15, No. 5, 10.2010, p. 639-644.

Research output: Contribution to journalArticle

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